Risk factors for severe Acute Respiratory tract Infections (ARI) in children under five years of age in an Urban Bangladesh Community

Abstract

Three hundred and sixty children under five years of age were enrolled in this study. They were diagnosed to have ARI according to WHO clinical ARI classification. Severe ARI (180) and non severe ARI (180) cases were considered as cases and controls in this 1:1 unmatched Case- Control study. The primary objective of this study was to identify the important risk factors for severe ARI. Both the cases and controls were selected from the same urban setting; Children Hospital, Dhaka. Bangladesh. Cases were admitted in the Hospital, treatment and investigations were done. Controls were followed up on their revisit or in the community whenever necessary. A standardized questionnaire, clinical examination and investigation were the main instruments of the study. Very young infants (0-5 months), low birth weight, lack or less duration of exclusive breast milk after birth, poor ventilation, poor nutritional status, biogas used as cooking fuel, non compliance with vaccination and incidence of diarrhoea in last fortnight were identified as significant risk factors on univariate analysis. However using the multiple logistic regression model only last four variables were demonstrated as having high odds ratios with valid confidence intervals and significance at p < .05. These findings could be valuable to the national ARI control program, specially when preparing the future intervention program. These could be also important message to intensify EPI program, to control quickly and effectively diarrhoea in children and to promote nutritional education program. This could advocate to provide families facilities to cook with gas rather with biogas. Finally the physicians could utilize this to provide appropriate advises in their day to day practice.